Get C1138

The C1138 form is essential for submitting short term home assistance invoices. This guide will walk you through each section of the form to ensure you complete it accurately and efficiently.

Follow the steps to fill out the C1138 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by entering the WCB claim number in the designated field at the top of the form.
3. Provide your surname, first name, and initial in the respective fields. Make sure to print clearly or type for legibility.
4. Fill out your complete address, including street, city/town, and postal code.
5. Input the date of service. This should be formatted as year/month/day.
6. Insert your date of birth using the year/month/day format.
7. Record the date of the accident in the same year/month/day format.
8. Identify the name and address to whom the fee is payable; print this information clearly.
9. Describe the service provided in the corresponding section.
10. Enter the hourly rate you are billing for the services rendered.
11. Specify the number of hours billed for the service, ensuring accuracy.
12. Document the date associated with the service rendered.
13. The provider must sign the form in the designated area.
14. Calculate the total cost for the services and enter this amount in the appropriate field.
15. Print the provider's name and include a contact telephone number.
16. If applicable, provide the fee code SSF08 in the space specified.
17. Once all fields are completed, you can save your changes, download, print, or share the filled out form as needed.

Complete your documents online today for a seamless experience.